How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $81.28 Median $186.21 Typical High $8,317.64 | Facility | None | $81.28 | $186.21 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $120.23 Typical High $173.78 | Professional | None | $51.29 | $120.23 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $69.18 | Professional | None | $47.86 | $57.54 | $69.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $87.10 Typical High $104.71 | Professional | 50 · Both sides | $72.44 | $87.10 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $79.43 | Professional | None | $54.95 | $60.26 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $251.19 Typical High $1,621.81 | Facility | None | $91.20 | $251.19 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $107.15 Typical High $158.49 | Professional | None | $50.12 | $107.15 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $181.97 | Professional | None | $117.49 | $141.25 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | None | $144.54 | $181.97 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $131.83 Typical High $245.47 | Facility | None | $81.28 | $131.83 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $134.90 | Professional | None | $53.70 | $77.62 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $56.23 Median $371.54 Typical High $2,454.71 | Facility | None | $56.23 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $275.42 | Professional | None | $109.65 | $151.36 | $275.42 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $38.02 Median $85.11 Typical High $186.21 | Professional | None | $38.02 | $85.11 | $186.21 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $48.98 Typical High $75.86 | Professional | 52 · Reduced service | $25.70 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $19.50 Typical High $30.20 | Professional | 53 · Discontinued | $10.23 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $74.13 Typical High $114.82 | Professional | 54 · Surgery only | $38.90 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $14.79 Typical High $22.91 | Professional | 55 · Aftercare only | $7.76 | $14.79 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $9.77 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.13 | $9.77 | $15.14 |
Where Virginia sits
The same service costs 3.4 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 50th of 51
$72.44
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.